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NPI Code Detail

MEDICARE: GRACE WACHIRA RN

MEDICARE: GRACE WACHIRA RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program316797NC

General Provider Information

NPI Number : 1194665497
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE WACHIRA RN
Provider Business Mailing Address
First Line : 6525 HORSEBACK LN
Second Line :
City : RALEIGH
State : NC
Zip : 27610-6678
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6525 HORSEBACK LN
Second Line :
City : RALEIGH
State : NC
Zip : 27610-6678
Country : US
Telephone Number : 678-478-3707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2026
Last Update Date : 03/30/2026

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